Name of the Child
Responsible Adult
Adult's Phone Number
Home Address
Please list any medical concerns above.
Accept Liability Waiver
By checking this box, I, the undersigned parent or legal guardian, hereby agree to hold harmless and indemnify [Church Name], its employees, volunteers, and agents, from any and all claims, liabilities, or legal actions arising from or in connection with any accident, injury, illness, or other incidents that may occur during my child's participation in the Vacation Bible School (VBS) program. I acknowledge that I understand the inherent risks involved in such activities and voluntarily assume responsibility for my child's participation. I further waive any right to initiate litigation or seek damages against [Church Name] or its representatives related to any such incidents. This agreement is binding upon my heirs, executors, and assigns.